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HIV management

In patients with established HIV, anti-retroviral therapy (ART) should be initiated as soon as possible after diagnosis.

ART initiation within seven days of new diagnosis improves viral suppression.

Randomized trials shows significant improvements in viral load suppression at 10 or 12 months and retention in care with the rapid initiation of therapy.

ART  has led to dramayic improvements in the health of patients with advanced  HIV in the prevention of disease progression in those without obvious clinical manifestations of HIV.
ART provides a new normal life expectancy for most patients with HIV who adhere to their treatment regimens.
 
It has eliminated the risk of transmitting the virus to an infected sexual partner.
 
Treatment with ART as a preventative measure has been a critical addition to the prevention of HIV with condom use, male circumcision, and screening of the blood supply.
Monthly injections of long-acting cabotegravir and rilpivirine were noninferior to standard oral therapy for maintaining HIV-1 suppression.
Pre-exposure prophylaxis studies has led to the conclusion that once daily single pill regimen is 99% effective in preventing sexual acquisition of HIV infection by an at risk uninfected person.
Patients with HIV infection, who received statins had a lower risk of major adverse cardiovascular events in those who receive placebo over median follow up of 5.1 years (REPRIEVE investigators).

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